Maheera Farooqi1, Yusra Tahir2, Bahar Rehan3. 1. 1MBBS, Department of Internal Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi-74200, Pakistan.. maheera.farooqi4321@gmail.com. 2. MBBS, Department of Internal Medicine, Bahria University Medical & Dental College, D.H.A. phase 2, Karachi Cantonment, Karachi-75500, Pakistan.. yusratahir42@gmail.com. 3. 1MBBS, Department of Internal Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi-74200, Pakistan.. bahar.rehan123@gmail.com.
Anemia is one of the most common preventable global public health concerns, especially in our part of the world, which account for more than 89% of the burden. Nutritional iron deficiency anemia is the most widespread anemia worldwide, affecting mainly children and women of reproductive age (1). however, according to several studies done worldwide, anemia is a common clinical finding in a particular population, yet often goes unrecognized, sometimes for a long time, and does not get managed. This seemingly neglected population in question comprises people of all ages and gender with diabetes mellitus Type 2, the most common type.The co-existence of diabetes and anemia, especially among patients with diabetic nephropathy, in which the proportion of patients with anemia was far higher, adversely impacts a person’s overall health and quality of life. (2). Even though diabetic nephropathy is a prime cause of anemia, a study conducted by Goldhaber A et al. shows that diabetes independently can increase the risk of anemia even in patients with normal renal function. (3). Another study describes that diabetic patients are twice more likely to have anemia than non-diabetics and patients with renal pathology from other causes. (4). It alludes to the fact that several risk factors come into play and need to be explored scientifically, especially in Pakistan, because the information on the prevalence of anemia and its associated risk factors in diabetic patients is scarce. It is essential because anemia in these patients may amplify other diabetes-related complications by exacerbating hypoxia-induced organ damage. There is evidence that a significant increase in the risk of all-cause and cardiovascular mortality, irrespective of other confounders, (5). and diabetic foot ulcers are strongly associated with the concurrence of anemia in diabetic patients. (6).Hence, Pakistani primary care doctors need to acknowledge anemia as a co-morbidity in diabetic patients and identify and treat the causes behind it. It could be done by routine screening with thorough clinical examination and blood tests for anemia for all diabetic patients, especially those with established kidney disease, cardiovascular disease, and geriatric patients. It would lead to early recognition and hence management of anemia, ultimately improving quality of life. However, there is not enough evidence that supports whether early management of anemia in diabetic patients can improve overall mortality. Thus, more research is required to prove if it is significant.